Chiropractic Craniopathy and Sacro Occipital Technic

By: Kurt Larsen, DC, FICS

Do you have patients with signs and symptoms resistant to your care? Would you like to enhance your abilities to provide exceptional service to your patients? How much of the nervous system do you influence? Utilization and incorporation of Cranial and Sacro Occipital Technic (SOT) methods will expand your effectiveness in each of these areas.

The Beginnings of SOT

Nearly 80 years ago M. B. DeJarnette, a Chiropractor, observed an osteopath demonstrating cranial manipulation. There were both profound positive and negative effects from these adjustments. Dr. DeJarnette theorized there must be a systematic way to approach the human frame to achieve these profound effects in a predictable, manageable method.

His adjusting skills and clinical research, which came from an intense desire to understand the subluxation and its effects, led Dr. DeJarnette to document and teach his method as the Sacro Occipital Technic (SOT). He founded the Sacro Occipital Research Society, International (SORSI) in 1957, with the purpose of allowing others to teach, assist him in research, and continue his work after he retired.1

The result of this intensive undertaking is a predictable, consistent method of diagnostic indicators leading to the primary cause of patients’ neurological disruptions during each visit. By continuing to evaluate these physiologic indicators, adjustments can be monitored visit to visit for their effectiveness, as well as to determine the next application most likely to achieve the best results.

Methods and Techniques

An overview of Chiropractic Craniopathy and SOT reveals several components:

  • Category Blocking Methods – mainly addressing spinal distortion
  • Chiropractic Manipulative Reflex Technique – addresses the somato-visceral organ reflex distortion
  • Extremity Technique – used in conjunction with Category correction and Cranial Technique

The utilization of Chiropractic Craniopathy techniques enables Chiropractors to influence the 80% of the nervous system from the neck up. Since this 80% controls the other 20%, many persistent spinal conditions respond favorably. Although some of these methods require specific, pre-cranial spinal corrections, many techniques can be integrated into your current practice.

Adjustments for sinus congestion, equilibrium disruption, blocked Eustachian tubes, temporo-mandibular joint dysfunctions, headaches, migraines, sub-occipital muscular tension, and fixated cervical vertebrae can often be incorporated into your current techniques after a few basic diagnostic checks. Other adjustments for deeper cranial distortions and emotional release require specific pelvic and spinal correction prior to addressing the cranial component. There are methods to help infants with many of their disruptions as well. Powerful adjustments exist for earaches, colic, cranio-facial distortions, and birth trauma.2,3

Stability from the Bottom Up

One of the key requirements before doing many cranial adjustments is to ensure that the sacroiliac joints are stable.4,5 This is one of the major differences between Sacro Occipital Technic and Cranial-Sacral Therapy. As the name implies, SOT starts from the bottom and goes up. This is where Dr. DeJarnette found a way to achieve his goal of a systematic, predictable approach in the application of cranial methods.

In achieving spinal integrity and pelvic stability, the Category System of Blocking is at the core of SOT. The basic miracle of the pelvic and spinal blocks is their ease of use and comfort they almost instantly give the patient.6 Standing, supine, and prone evaluation yields indicators that direct the Chiropractor to a clinical impression of a preponderance of a specific category. That category contains basic areas of focus, which narrow the types and areas of adjustments needed. The result is a powerful, direct approach to patient needs.

The three main categories are I, II, and III. Each has its own specific characteristics as well as methods and protocols for care. (Space restrictions prohibit an in-depth discussion of categorical blocking positions in this article; for more information, call 1-800-553-4860 for a current listing of SOT seminars around the country.)

Category I. Category I refers to the fixation of the synovial boot portion of the sacroiliac joint with associated meningeal system disruption. The spinal and intra-cranial dura is involved, along with the neurology, physiology, and reflexes of the central nervous system.

Category II. This category involves dysfunctions of the weightbearing part of the sacroiliac joints. This usually involves a tear, sprain, or strain of the hyaline part of the sacroiliac joint, and can have far-reaching consequences due to the effect that this problem has on proprioception, the muscular system, and the temporo-mandibular mechanism and cranial sutures.

Category II conditions, whether acute or chronic, make up a substantial portion of the patient population. The complaints can vary from low back pain, mid dorsal pain, and extremity conditions to headache/migraine symptoms, emotional imbalance, and temporo-mandibular disorders. The correction of this type of patient is both rewarding and practice building, as often no one else has substantially helped them.

Category III. Category III involves the discs and their blood supply. Most acute low back/sciatic pain patients are predominately in this category. SOT has special procedures for the care of these patients that is both effective and safe.

Orthotics for Effective Response

With all category signs and symptoms, I have found it beneficial to incorporate Foot Levelers’ functional orthotics to assist the patient in maintaining correction and achieving proper rehabilitation. These custom-made orthotics have helped many patients who were not responding effectively. My protocol is to clear out at least part of the major pelvic and extremity distortion, then cast for the orthotics. The results have been to stabilize prior work and allow for further progress.

CMRT Application

The final method of SOT to be addressed is Chiropractic Manipulative Reflex Technique (CMRT). This organ reflex technique deals with common complaints in the Chiropractic practice. Many persistent spinal subluxations remain, due to the unresolved organ reflex that relates to that vertebra. The eighth thoracic is so common due to its reflex relationship with the liver. Common symptoms include multiple joint aches, headaches (especially the top of the head) and lethargy. First the appropriate occipital fiber is goaded while contacting the side of T8 posteriority, completing the osseous adjustment after a release is felt at the transverse process. Then five different anterior body and one posterior body contacts are utilized to decongest the liver and open the channels of drainage. This is just one example of application of CMRT.7

There is a lot to Chiropractic Craniopathy and SOT. Some methods can be incorporated into your current practice technique; others require some conversion to new protocols. Enjoy what you do to help others!


  1. DeJarnette MB. History of SOT.
  2. 1979-80 DeJarnette Cranial Technique: Anatomy and Physiology of the Cranium.
  3. Bathie. 1996 SORSI Cranial Technique Manual.
  4. 1984 DeJarnette SOT Manual.
  5. Bathie. 1996 SORSI SOT Manual.
  6. DeJarnette MB. The Blessings of Sacro Occipital Technic, Vol. 3 #11. Sept., 1968.
  7. Bathie. 2000 SORSI CMRT Manual.


Dr. Kurt Larsen ranks as one of Chiropractic’s foremost experts on Sacro Occipital Technique and Craniopathy. A graduate of Northwestern College of Chiropractic, Dr. Larsen practices in Hot Springs Village, Arkansas.